目的：探讨经外侧眶上-侧裂岛叶入路与颞部直切口小骨窗皮层入路显微手术治疗基底节区高血压脑出血的临床疗效。方法：总结我院2011年6月至2014年6月44例基底节区高血压脑出血患者的临床资料。结果：经外侧眶上-侧裂岛叶入路23例，72 h内清醒者15例（65.2%），2周内清醒8例（34.8%）；经颞部直切口小骨窗皮层入路21例，72 h内清醒者9例（42.9%），2周内清醒10例（47.6%），2例持续昏迷。两组均无再出血需二次手术患者，左侧优势半球血肿行颞叶皮层入路术后失语的几率明显增加。结论：经外侧眶上-侧裂岛叶入路手术时间短，创伤小，血肿清除率高，术后并发症少，病人恢复佳。该入路更符合微创理念，是治疗基底节区高血压脑出血的理想手段，值得优先考虑。

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